The liver is an extremely instrumental organ in the human body. It not only aids in proper digestion but also fights outside infections that threaten the immune system in the body. Liver cancer and failure of it to perform its assigned functions are extremities of diseases faced by the liver. Hence, to avoid further complications such as spread of cancer, liver cancer surgery is the best option available.

Why is Liver Cancer Surgery Required?

Liver cancer surgery usually is for life-saving purposes. In some cases, cancer is totally removed from the liver, but in some cases, surgery helps in making the patient survive for longer than expected. Also, surgery is useful in stopping the advancement of cancer to the remaining parts of the body from liver. Depending on the condition, doctors decide the type of surgery method to be adopted.

Pre-operative Preparation

When doctors come to a conclusion that surgery is the only respite left for treating cancer, the surgery decision is confirmed for the patient. There are certain diagnostic tests that the patient is made to undergo before surgery. Few of them are as follows:

Biopsy: Entails excision of a small amount of liver tissue for analysis. It is ordered so that the extent of progression of the tumor before the surgery is known.

ECG: An electrocardiogram is ordered before the surgery for examining the overall functioning of the heart.

CBC: A Complete Blood Count (CBC) provides an idea of the platelet count along with red and white blood cell count. A difference in the CBC from the normal range may alert the doctor about any possible infections and so he/she may reschedule the surgery totally.

Blood sugar testing: Blood sugar levels are also needed to check before the actual surgery.

Following given are the instructions patient needs to follow once surgery date is decided. The date for surgery is also then scheduled.

Day Before Surgery

Having to undergo surgery for liver cancer or for that matter any other cancer is a very distressing time for the person and his family members. Therefore having an idea as to what goes into the preparation stage can brace the person for taking precautions and then going in for the surgery. Following given are some other steps you can take to help ensure a better surgical outcome on your end:

Rest and diet: Make sure to get plenty of rest. A healthy diet can help prepare your body for surgery.

Smoking: You need to stop smoking at once when you get a go ahead for the surgery. Smoking can really delay recovery and slow the healing process. Lung complications can also be an after effect of the surgery.

Pre-surgery tests: The doctor will make you undergo few requisite tests before surgery to know the levels of your physical well-being.

Instructions: It is better to ask your doctor beforehand about the things necessary for looking after the incisions post surgery and the dosage of medication. Follow these instructions carefully. Know which side effects after surgery are normal and which may be signs of a complication.

Leg exercises: The physiotherapist will teach you few leg exercises you need to immediately start doing post surgery for preventing formation of blood clots in your legs along with the medication prescribed.

The probability of getting back to a fit and fine body like before depends on many factors like - the progression and growth of the tumors to other parts of the body, whether the person is having cancer for the first time, or whether his earlier cancer has relapsed. It also has got a lot to do with the person's general health, whether he has any other liver condition, and lastly if the person is a likely candidate for liver transplant if the cancer is not possible to go away by removal of the affected part of liver.

While the above mentioned were the types under which cancer is classified and the chances of recovery, the line of treatment varies according to patient. There are few types of standard treatments that are used for treating any person suffering from liver cancer. They are as follows:

Methods/Techniques of Liver Cancer Surgery

Liver Resection: Surgery for resection of the liver to remove affected parts is called liver resection. The surgery for it is also referred to as partial or full hepactectomy. Surgical resection of liver is feasible because liver is an organ that has regenerative capacity. A liver transplant becomes compulsory when the liver function is very poor and not up to the mark. At such times, removing the affected portion of liver would only result in liver failure, transplant from a donor is helpful. In such liver cancer cases, the old liver is removed and fitted with a new one.

Minimally-Invasive Laparoscopic Liver Tumor Resection A laparascopic procedure is decided based on the size and location of the tumors. In this minimally invasive approach of surgery for liver cancer. One or multiple incisions are made for being able to insert the laparascope. The incisions enable the doctor to insert the cameras and surgical instruments for performing the resection surgery. The minimally-invasive surgery involves faster recovery, less blood loss and lesser postoperative pain, fewer and smaller scars as compared to an open surgery. Depending on your condition, you may need only a short hospital stay.

Cryosurgery: This technique commences with the patient getting a general anesthetic injected. A thin metal probe then freezes the tumor with the help of cold gases that destroy the cancerous cells. The probe is inserted through the abdominal skin during this technique which is used for treating liver cancer. This method is also called as Percutaneous technique. The metallic probe may sometimes be inserted in the abdominal cavity for operating on the tumor. This technique is termed as intra-abdominal surgery.

Liver Transplant: A liver transplant is another surgical technique for elimination of liver cancer from the body. This method is not advisable for people suffering from bile duct cancer. Also, only people with one or multiple small liver tumors are considered for this treatment. It involves removing the entire liver for eventually replacing it with a healthy liver taken from a donor. People suffering from liver cancer and those who qualify for a liver transplant need to wait for a long time for getting the correct donor. As a result, cancer continues to grow and at that time, tumor ablation therapy is considered suitable for the patient till time being.

Isolated Liver Perfusion: This method is only used in rare liver cancer cases wherein the cancer is failing to respond to other surgical techniques. The name comes from, the procedural step wherein highly concentrated chemotherapeutic drugs are infused into the liver. As a result, hepatic circulatory system is separated from other sources that supply blood to the body.

Other than the above treatments, targeted therapies, chemotherapy, palliative treatment and radioembolization are used for treating patients suffering from liver cancer. That is decided of course on the basis of type, staging and progression of tumors.

Post Procedure

The surgery duration depends on the complications and progression of the liver cancer inside. The time will differ from patient to patient.

Recovery area - You will be moved to the recovery area from the operation theater once your surgery is done.

IV-drip - An intravenous fluid drip is connected to a vein in your neck for giving you fluids and medicines.

Catheter - A catheter is left in your bladder for proper urinary functioning for 2-3 days from the surgery. Thereafter, the patient is kept in a High Dependency Unit to be kept under observation for few more days till he is declared fit to go home.

Do's and Don'ts...Post-Liver Cancer Surgery

Following listed are the recovery tips to be followed in the period post undergoing any of the above treatments listed for liver cancer of any stage.

Incision care - The dressing placed to seal the incisions used during procedure need to be kept clean and infection free.

Fatigue - It is normal to feel tired and upset over the few days post surgery. Memory retention and concentration is also very difficult; let it pass.

Plenty of rest - You should allow yourself plenty of rest once you get the discharged from the hospital.

Return to work - 3-4 weeks time is enough for cooling off the effects of surgery and returning to work thereafter. However, your doctor can be the best judge to advice about getting back to work.

Alcohol - You should stay away from alcohol consumption for at least 6 weeks after surgery.

Diet - It is advisable that you avoid eating hard or crunchy foods in the early part of your recovery period. Prefer juices, soups and related fluids that will keep you hydrated as well as energetic.

Frequency of food intake - The gaps between food intake in the entire day should not be too much. This is so as to not disturb the liver functioning further more, as the functioning post surgery is obviously disturbed.

Adequate nutrition - Make sure to include a balanced diet and nutrition categories in your everyday food post surgery. This is helpful not only in improving liver functioning but also in promoting regeneration of liver post any surgery for cancer elimination.

Laxatives - You may be requiring laxatives for the first few days to have a smooth bowel movement. Emphasize on eating specific fruits like kiwifruit and prunes to clear the bowel properly without medication.

Risks and Complications

There are few complications associated with liver cancer surgeries mentioned above.

Liver Resection Risks

Bleeding post surgery is a common complication. Also, development of blood clots in legs post operation which is also known as deep vein thrombosis is another possibility. Infections developing at the site of surgery and leakage of bile from liver are 2 other complications coming with the liver resection procedure.

Liver Transplant Risks

Liver rejection is the most common side effect. It happens because the transplanted liver is relatively new to the body and also to the immune system. As a result, diarrhea, reduced energy levels, yellowing of skin and fever with high temperature are experienced by the patient. Also, there are likely side-effects because of medicines used during transplant that may cause high cholesterol, high blood pressure, weakened bones and kidneys etc.

Cryosurgery Risks

Cryosurgery done for treating the liver cancer may cause hemorrhage, infection, damage to major blood vessels and bile ducts and at times also relapse of the cancer

This page included information on liver cancer surgery types and every detail a patient ought to know about what happens during, before and after surgery. The treatment method; whether surgical or non-surgical, depends on the age, grade of tumor, overall health and extent of progression of the tumor in the person's body.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Liver cancer is when the cells in the liver grow uncontrolled. As the liver filters blood from all parts of the body, one of the most common reasons for liver cancer is perhaps metastasis, which is spread from other parts. Through the blood, cancer cells from other parts reach the liver for filtration and can then make the organ cancerous.

In addition to this, there are other risk factors that can lead to liver cancer. For example, people suffering from obesity, alcohol and tobacco abuse, viral hepatitis (B or C), chronic liver disease (especially in men, who are more prone than women to develop cancer), cirrhosis and someone who has a history of a prolonged use of steroids can suffer from the disease. Also, while liver cancer is very rare in the Americas, it is very common in Africa and Southeast Asia as the prevalence of hepatitis is higher in these regions.

When it comes to the symptoms, it’s acceptable that liver cancer is insidious, and the exact point of origin cannot be identified. It continues to grow until symptoms become evident, which are also nonspecific. Before analyzing your health on your own, it’s always recommendable to seek an expert’s final word on it. Let’s take a look at the top signs that might point out towards liver cancer.

Abdominal pain: When you suffer a strong pain in the abdominal area, especially in the upper portion on the right side, it can signal a lump or a growing tumor in the liver. This can also be accompanied by middle or lower back pain.

Weight loss: Many a time, women who suffer from a sudden loss of weight can be going through a deadly disease like this one. In most cases, these weight loss cases show no attempts on the patient’s side, that is, the weight loss occurred for unknown reasons. A loss of appetite, without any reasons, is another indicator. These can result due to unexplained reasons and should be taken seriously.

White, chalky stools:This one is another tell-tale sign of liver cancer. Often, people tend to ignore stools in light, flaky colors. It is always better to consult a doctor, as you might be ignoring a sign of potential cancer.

Bloating: When you feel certain heaviness or bloating in the upper part of the abdomen due to fluid accumulation it indicates, which is one of the indicators for testing liver cancer.

Frequent body conditions: Apart from the above mentioned symptoms, one can also consider personal health history when facing any liver- related problems. Recurring severe nausea and vomiting and general signs of lethargy and weakness can also indicate liver cancer. Also, personal health history with claims the patient suffered from jaundice (due to the accumulation of bile pigments in the sclera and skin) can also be taken into consideration. If you wish to discuss about any specific problem, you can consult an Oncologist.

HI lybrate-user, As per your history disease of GI Junction with Liver metastasis, I Presume you want to say about GE junction, Post 2 lines of Chemotherapy and progressive. The overall picture is not happy, it will be advisable to meet the surgical Oncologist if I assume the ascites and pleural effusion is not disease related. If Ascites and Pleural effusion are disease related, which is more a possibility as per case scenario, there are limited options. One vital option would be targeted therapy, with Herceptin if not already instituted in case of Her 2 +ve cancer. Overall with limited information, I feel the picture is quite gloomy. Having said that, ultimate power is GOD, so don't lose hope and Keep fighting. Good luck.

A liver transplant surgery involves surgically substituting a problematic liver with a healthy liver from a different person. Usually, the healthy liver is taken from a person who has recently passed away. In some cases, a living person may also give away part of the liver. Usually, living donors are members of the family or someone who has a good blood type match. The liver regenerates lost tissues after a surgery; hence, the donor’s liver becomes normal within a few weeks of surgery.

You may require a liver transplant if your liver does not function optimally, owing to the below mentioned conditions:

Cirrhosis: This is a chronic disease of the liver wherein, scar tissues replace healthy tissues in the liver, thus, not allowing the liver to function optimally.

Metabolic disease: Disorders that modify the activity of the chemicals in the body

Acute hepatic necrosis: This is a disorder that causes the healthy tissues in the liver to die

Autoimmune disorders or liver cancer: Autoimmune disorders can cause healthy tissues in the liver to die as the immune system in the body starts attacking healthy tissues. Formation of malignant tumors in the liver can impair liver functioning.

Procedure
You have to undergo certain procedures before the surgery is conducted; a general health exam, imaging tests, blood tests and a psychological exam are conducted before the surgery. Based on the functioning of the liver and some other factors, your suitability for the transplant will be determined.
The procedure begins with general anesthesia, following which an incision is made in the abdomen. The liver is then removed and replaced with a healthy one. Once the procedure is completed, the surgeon closes the incision with stitches.

Aftercare
Once the procedure is done with, you are kept in the intensive care unit for a few days. The doctor will monitor your progress and put you on medications. After the recovery, you will have to undergo check-ups at regular intervals. You may also have to take medications such as immuno suppressant to prevent your immune system from attacking the liver. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.